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.~- PERMITTEE NAMEIAODRESS pwrYb isWryNrW!<e•nm dDlQiraO NAME SENcCA CDAL COtlPANY ADDRESS D&ArER D HAYilEN CO 41639 FACILITY IOCATIONBAY JLN CO 81630 A'[YN: G. 6UD BNDYM, G6NEHAL lIAYAGRR Form Approved. ~? :, i~UTE YET TESTINC.,OMeJKo.go'4Q-good' '' , (SUER NY} Approveie~gt~~05-31-98~ F - FILIAL ' ~ '1 I N OR r assn""', DISCHARGE I~I ;YtY D ,ilti~d lnetructlaro Delon eompbtinp tbie form. PARAMETER 13 rrd ontyl QUANTITY OR LOADI Id urd onlFl QUANTITY OR CO C TION ~ ~ NO. FRE°UENCr SAMPLE 146-531 15L811 738-e51 /46-53 ' 15461/ EX of TYPE 132-371 MALYSIS AVERAGE MAXIMUM U MINIMUM AVERAGE MAXIMUM UNITS lezs3 164681 169-701 5 'rR 4 NH AC SAMPLE +-`+GSa >3CtOO+at #>ftlldk#G v#r+#'.r ( 23) C~nIUiIAPHNIA MEASUREMENT TAP..iB 1 U 0 PERMIT. T3 .:#: Ar.... AF# ..,;>.:. ,.:. "` ~; .;;# #k GRAI'G LA- '~1'$Yc<' :RA$r%ir r,FFLUdNT GR05S YALUF .REQUIHEMENT: .. ~#Oa ~ s '3t)I.Lt1:E:. CENT :. SAMPLE . ~ ', ~~~?:T MEASUREMENT ~''~+'~; PERMIT .. ... .. .. ...~ '. ~~+ .~ ~ ~. ~.. :::':.;:.~:tll:""<.<~'-:f ..:~. .: ~ t.; ~ ::v:". `?5;,.::::.: ~:: ..' :~ . :REQUIREMENT 1,S M.~.t Vn u V'Q PK~ . .. - ~: {: ~- " ` SAMPLE MEASUREMENT ~ aV SVy ~q ~ ~ ) Z ~ ~ ~ .: PERMIT ~ ~ ~ ~. ~ .: ~ ~ :: ~ ~ ... ~ :_` . I i..::;f ~i. j REQUIREMENT. . .. ~. :~ :~: .: .::~~.:~::: ; ; '; ~ ;::' , . :. ~.. SAMPLE MEASUREMENT : ~ ~~PERMIT~ ~:~. ~ .. ~ :~.:~ - „`ri ~ . ' ~ . .REQUIREMENT :. .... ~~ :::.... : . ~: : ~. ~ .. ~ ~ ~. .: ~..`~ :`"'~rs;':i:_;~.:.'.:.:~. ~(:°.~`~.,...~::` ~::.~ ~ ,. 3;.:: . ;,r.:,:...' . SAMPLE MEASUREMENT :: ~::. PERMIT . ~ .. .... ..... . ,.x ~ ~ ~ :REDU.IREMENT~ ~. :.:. ~:.: :~ ::~ . :~::~.. ~. .:~:~:i ~'. ~:.: ~~: ~:?u'~_~~K: ~::.: ~ ~.'; SAMPLE MEASUREMENT ; . REQUIREMENT: ~~ ~ ~•: ~ ~ ~~~: ~ ~ ~ ~~ SAMPLE MEASUREMENT ... 'PERMIT: :~.~ ~. .: ..: ~~~:~ .: .:.: ..:...:...... .. .... : ~ .. ~ ~ ~ REQUIREMENT: ;:. ::: ~::::'~;::~:~;'= .. .. ~:::: ~::; ::i~ >: :.: :; ~:: ~:~ :~::, ~.~ ~ ~. ::. .;~`~.: :.: .;~..:.~; . ':.:: ; ~:~::: 'r ~:::~~: . . . . : . : . . NAMEffITLE PRINCIPAL EXECVTNE OFFICER I CERTIFY UNDER PENALTY Of LAW TNAT I NAVE PERSONALLY E%AMI NED MD S TELEPHONE DATE AM FAMILIM WITH THE INFO MY INQUIRY OF THOSE IN RMATION SUBMITTED HEREIN; MO BA DINDUALS IMMEDIATELY. RESPOf/51B ED ON LE FOR OBTAINING THE INFORMATON , I BELIEVE 1NE SUBMITTED INFORM ATION IS / TRUE. ACCURATE MD COM SIONINCMT PENALTIES FOR RETE. I AM AWME TNAT THE SUBMITTING FALSE INFORMATION IN RE ME CLUpING ~ ~ O I -' THE fN)SSIeIUTY OF RNE MD , IMPRISONMENT. SEE 1B U.S.C. ! 1001 MO 39 u.B.D. 1 late. IAvrro.+1•rer ew•• mnm• m+r hrwei r+w+ye ro aro,ooD SIGNATURE OF INCIPAL E7tECUTNE TYPED OR PRINTED rvum++hwn M-dayvMnt •/A•rwwlemenM+W 61'•+rA/ OF.FlCER ORA HORI2ED AGENT CODE NUMBER YEAR MO DAY COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Referents ell ettschments here! SEE PART I. A.4 fOR DETAILS JF TEST PROC(;DUItE. 4EPD81 LJa£ST flI~tiTI01f (X EFFLDENT) YNICN 15 LETHAL TO SU+ uF '[EST ORGANISHS (LC50) A9D ATTACK ACUTE TOAICITI TEST REPORT FORT; T~ UdR. COPIES Op ALL ' INF'TNNATLON L7IIST RP 5R1LT ~O RDi~ EPA Form 3320-T (08.86) Prsvioue~editions mey. bft depd,4~. ~,_, ..~~,. _,_ IR.~LACEB, EPA FORM T~40 WHICH MAY NOT.BE.USED.1 QADaB/9B O9S K-0923 PAGE lOF ,